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Multidetector row computed tomography (MDCT) has the potential to provide high-resolution multiplanar imaging that can help in accurate diagnosis of small bowel obstruction. Reformatted multiplanar images can increase diagnostic confidence in identifying transition points causing obstruction and also allow accurate delineation of various pathological conditions. Accurate and early diagnosis of complications associated with small bowel obstruction can also help in the clinical management of patients. In appropriate clinical scenarios MDCT angiograms may also be performed. Furthermore the rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of common and unusual diseases causing small bowel obstruction as revealed on MDCT.

Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

We report a 40-year-old man with sloughing off of the colonic due to tuberculous associated with HIV infection. He presented with lump in the abdomen, distention and vomiting suggestive of intestinal obstruction. Proximal loop ileostomy with closure of colonic perforation was performed, with good recovery. This was followed by antitubercular chemotherapy.